An Issue Briefing Report

Introduction

Municipalities are struggling with an ever ballooning health care costs, public-private partnerships in managing and the construction can offer innovate ways to control and provide better services. Experience has shown that such partnerships can offer huge benefits so long as policymakers structure and create a good regulatory framework to ensure universal access, quality care and improve efficiency (Choudhry, 2013). In Australia, the Mildura Hospital Contract that was awarded in 1999 is an example of one of these private public partnerships in the health sector. The contract was an arrangement where a private operator designed, set up and operates the 153 bed hospital for 25 years. The government in return makes annual payments to the private operator based on the forested number of clinical patients that are treated at the hospital, with a cap however on the funding up to certain agreed on number of patients. There was also a block grant that covers some capital costs such as teaching. The results of the private public partnership that is Mildura Hospital have been good with capital costs for the new hospital being over 20 percent below hospitals that were fully publicly owned and operated (Ramesh, 2010). The cost of clinical services is also lower than that of other hospitals and Mildura has met all its performance targets with patient volumes increasing by 30 percent in the first year (Siggerud, & United States, 2008). The Jeddah Municipality plans to enter into agreements with private companies for the management of public hospitals that were built and funded by the government. The main objective of the government is to improve the efficiency of operations, elevate the quality of services and undertake a shift of operational risks (Imhoos, et al, 2001). In such an arrangement, the private operators acquire new employees and manage the facilities (among them medical services) in contracts that are funded on a yearly basis and goes for up to five years. The operators are required to attend to all of the patients that visit the health center. The government, on the other hand, is required to pay for the medical services with regard to the projected size of patients that visit the center. The operators have to acquire about 80 percent of projected number for payment to made, though they are not reimbursed for targets that are exceeded (Al-Aama, 2013). Therefore, this issue requires a means through which both parties engage to deliberate and negotiate in order towards mutual beneficial relationship. We at Communication Engagement Consultants (CEC) have been hired to solve communication issues between the Jeddah Municipality and private health care providers in Jeddah Municipality to foster a mutual beneficial relationship and achieve their goal of providing universal access to quality healthcare and improve efficiency. This paper looks to assess the effectiveness of the Jeddah Municipality and the partnerships established by public and private health care centers in achieving their goals for quality health care. The paper will go ahead to offer recommendations on the management of these partnerships for effective outcome.

Issues Clarification

Taking into consideration that public and private partnership to be important in the improvement of quality of care and management of cost, Jeddah Municipality have to be aware of the certain issues:

Universal Access: Every person has access to health care. Some contracts require the provider to go on offering service to all public patients. The provider may at times be compensated by the government, though at times may he accepts the financial threat on assumption that it will lead to cross-subsidies from the patients and financing bodies.

Funding: Governments in most cases finance public health centers using budgetary payments or insurance schemes. Not long ago, governments have moved from input costs to clinical mix of patients to be handled. With a change to private management, added focus has been allocated to connecting the public funding (be it from budget or public insurance) to performance while similarly appreciating the quality of care and patient comfort.

Consolidation: Most countries have several public hospitals and will have to trim, consolidate and shut down certain facilities. The partnership formed by private and public companies can lead to consolidation of services (Carrin, 2010). Governments can tender certain facilities, making it possible for private companies to consolidate them while still offering some form of clinical services.

Competitions: rivalry between hospitals leads to quality and efficiency of operations. Governments ought to resist granting privately managed public hospitals special privileges. Similarly, where the government has some form of interest, there should be no discrimination to other hospitals.

Regulation: The regulatory models applied in hospitals is restricted to certain agencies that undertakes accreditation. However, the public and private partnership may lead to additional obligations that call for monitoring, sanctions and dispute resolution processes. This may call for the government to step in (Yescombe, 2011). Additionally, the government will have to focus on the extent to which they depend on regulation, legislation and certification or arrangements organized with the private providers. The experience on privatization process may mean that an independent regulator is required to monitor and impose public-private partnership contrast for health centers.

Issues Verification

The plan of the Jeddah Municipality enter into agreements with private companies for the management of public hospitals. The private sector in Jeddah Municipality and Saudi Arabia at large has developed to the extent of being almost autonomous from the state (Buchele, 2008). Thus, creating a good framework for private public partnership in healthcare sector. In addition, Jeddah Municipality has made significant efforts to have good working relationships with the private sector. Through the Jeddah Development and Urban Regeneration Company (JDURC), established by Royal in 2007, the Jeddah Municipality enters into development partnerships with private companies and investors (Jeddah Municipality, 2014). Therefore, JDURC partners with the players from the private sector in the development of Municipality land, regeneration of urban areas, and provision of open space and facilities (Grimsey, 2008). Jeddah Municipality is keen on ensuring transfer of knowledge from the private sector partners in order to increase government’s own capacity and capability. The municipality is committed to entering into strategic alliance with private companies only where there is value as relates to real benefits to the Jeddah community as well as knowledge to the municipality (Al-Aama, 2013).

Jeddah Municipality clearly appreciates the increasing healthcare costs. Public-private partnerships in managing and construction can offer innovate ways to control and provide better healthcare services. In this regards, the municipality must create a favorable climate where private companies and investors are willing to managing and the construction healthcare facilities to provide better healthcare services.

Conclusion

With the global economy still recovering from financial crisis, governments are finding themselves hard pressed to efficiently set up and manage hospitals and health care facilities. This has further been fuelled by rising costs of operations as well as public budget constraints. This has led to a deficit of available health care to citizens. One of the ways to reduce this deficit and improve the viability of the public healthcare system is to get into more public-private partnerships. These partnerships have proven to not only increase the number of operational health care facilities but also improve the efficiency and quality of services that are provided at these facilities.

Recommendation

These recommendations are made for public-private partnerships in the health arena so as to ensure effectiveness in service provision;

The objectives and success pointers have to be communicated and agreed by all the stakeholders through a signed agreement. This will call for constant monitor and analysis of the project to ensure everything is as per contract.

The implementation of the agreement calls for an experienced institutional body that will ensure effectiveness of the process. Moreover, both sides ought to be ready to compute risks that may arise in the partnership.

Lastly, as the partnership grows into a policy sensitive areas like healthcare, consideration has to be taken to expound on key issues so as to well manage aspects of sociality and politics that have extensive impact on the partnership outcome.

 

 

 

 

 

 

 

 

 

References

Al-Aama, A. Y. (2013). Using Balanced Scorecards to Manage IT Strategies in Public Organizations: The Case of Jeddah Municipality. Engineering Management Research, 2, 1.)

Carrin, G. et al. (2010). Health Systems Policy, Finance, and Organization. Oxford: Academic         Press.

Choudhry, A. et al (2013). A Public-Private Partnership Develops and Externally Validates a 30-          Day Hospital Readmission Risk Prediction Model. Online J Public Health Inform. 5(2):       219.

Jeddah Municipality, (2014). Jeddah Website. Retrieved http://www.jeddah.gov.sa/English/index.php

Imhoos, C., Verbist, H., & International Trade Centre UNCTAD/WTO (2001). Arbitration and alternative dispute resolution: How to settle international business disputes. Geneva: International Trade Centre UNCTAD/WTO.

Ramesh, G. (2010). Public private partnerships. New Delhi: Routledge.

Reddy, J. (2013). Role of Private-Public Partnership in Health Education: A Survey of Current Practices in Udaipur City, Rajasthan, India. Int J Prev Med. 4(9): 1086–1094.

Siggerud, K., & United States (2008). Highway public-private partnerships: More rigorous up-front analysis could better secure potential benefits and protect the public interest. Washington, D.C.: U.S. Govt. Accountability Office

Venkat, A. et al (2008). Public-Private Partnerships in Health Care in India: Lessons for   Developing Countries. New York: Routledge.

Yescombe, E. (2011). Public-Private Partnerships: Principles of Policy and Finance. Oxford: Butterworth-Heinemann.